Lack of energy

Many men with prostate cancer feel tired from time to time. One cause can be interrupted sleep when a man has to pass urine frequently during the night. However, radiotherapy and hormone treatment are known to affect energy*. National Institute for Health and Care Excellence (NICE) guidelines 2014 (CG175) recommends that men are told when starting hormone therapy that fatigue is a recognised side effect of this therapy and not necessarily a result of prostate cancer and they should be offered supervised resistance and aerobic exercise at least twice a week for 12 weeks to reduce fatigue and improve quality of life.

Expectations differ; some men reported that their sporting activities had become limited and others regretted that they lacked the energy to work or tackle household and garden chores. One man, who had a radical prostatectomy in 1993, also said that the operation had reduced his stamina and greatly affected his lifestyle.

Describes how a radical prostactectomy reduced his stamina and greatly affected his lifestyle.

Age at interview 63

Gender Male

Age at diagnosis 56

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The other side effects that I feel are honestly related to the operation of my battery power, as I call it. My strength is far lower these days than what it used to be. My stamina is nothing to what it used to be, the will to want to do those things in the early days was very strong and I suppose I’ve been one of those that has pushed myself to the limit. But having found out what my limits are, and they’re certainly far lower than what they used to be in any form of physical movement, coming to terms with that and readjusting my life to say I can do lots but they’re far less than what they were in the past, again is a salvation I feel. Learn to live with what life is now rather than what life was before.

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Discusses how radiotherapy affected his energy levels.

Age at interview 65

Gender Male

Age at diagnosis 63

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The other aspect, I like to run and Ive been running for about 50 years I suppose, even longer now 55. In the first place I was able to run very regularly. I was very fit before starting the treatment and I was able to run all the way through the treatment, but I found towards the end that I was becoming very tired. I found tiredness coming in and a little bit of ennui, lethargy, I was beginning to be not be as on the ball perhaps as I would normally be. Well enough to drive, well enough to do all sorts of things you know it wasnt major or anything like that but I was beginning to find running a little bit more difficult. And in fact I cut my mileage down towards the, I suppose the last 5 or 6 weeks of treatment, sorry the last 3 or 4 weeks of treatment I had to cut training down. After treatment I was still left with the problem.

Having had a word with the GP about it, how long would you expect the tiredness and the physical change to take place after radiotherapy and he said Well 3 to 6 months but its taken me a lot longer to get back. But then also I suppose I’m now 66 and theres an aging process too so it might not be due completely to the treatment. But the fact I had to cut down at that stage, it’s taken may be longer to get back into form, due partly to age, not necessarily due to the treatment. But having said that all normal things, after 3, 6 months I was fairly well okay again to do most things.

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Considers that hormone injections have caused him to feel lethargic.

Age at interview 80

Gender Male

Age at diagnosis 77

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Have the hormone injections had other side effects?

I don’t know, I think so in that I, now I cant think of the word, youd know the word, I’m ever so lazy, I don’t want to do anything, if it werent for my wife I wouldn’t even get up in the morning, I’m too bone idle

Do you think that might be the side effects of the injections?

Yes I do, I do, because I used to be someone, I carried on teaching and this is a boast, not full time but when I was 72, and enjoying it. Now I cant remember Ohm’s Law, I could no more teach than fly. But this terrible, I mean when youve gone I must get on and finish digging over that little bit outside, I’m dreading it.

The digging?

Just forking it over, planting a few wall flowers over, doing anything is a chore, I don’t enjoy it, I used to love it. I mean I used to get up early in the morning, work solidly until I dropped into bed, I have led a very active life, very active, even with my new hip and so on. I could, I felt Id never stop work.

And this is all you think as a result of the injections?

I think so but I don’t know. I said to my GP What is my trouble, old age, psychological or the cancer? and he said Yes.

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Explains how he felt tired after radiotherapy.

Age at interview 49

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Did you have any side effects as a result of the radiotherapy?

A little bit of tiredness but that’s about all. Apparently it affects people in different ways but all I experienced was a little bit of tiredness. I was still working at that time and my Governor didn’t mind me going up there every morning and I was still able to carry on working in the afternoons but it wasn’t physical work it was part mental work and part working with your hands because I used to repair fountain pens.

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*Newer hormone therapies such as bicalutamide (Casodex) are suitable for non-metastatic disease and it does not lower testosterone so patients should not become as lethargic or fatigued.

Bowel and bladder problems

Treatments for prostate cancer such as surgery, external radiotherapy and brachytherapy may cause damage or inflammation to organs near the prostate such as the bowels...